This proposal is designed to provide Dr. Rachel Hess with the research experience and analytic skills to become an independent health services researcher emphasizing women's health and health related quality of life (HRQOL). She will build on fellowship training in women's health and health services research with formal course work designed to increase her skills in epidemiologic and survey techniques, economic theory, and ascertainment of health services utilization (HSU) and directed study in HRQOL, HSU, and statistical techniques. She has the support of the Department of Medicine, Division of General Internal Medicine, and Center for Research on Health Care as well as the commitment of exceptional mentors: Roberta Ness, MD, MPH; Karen Matthews, PhD; and Wishwa Kapoor, MD, MPH. With her mentors' assistance, Dr. Hess will study the impact of menopause and hormonal therapy on HRQOL and HSU. [unreadable] [unreadable] Menopause affects all women as they age, yet its affect on HRQOL and HSU is not fully elucidated. Over the next 10 years, 50% of the United States population will be in or entering menopause. In 1997 alone, Americans spent over $21 billion on alternative medical therapies. Use of alternative therapies in menopause is not well quantified. Given the recent evidence of harmful effects of hormone therapy in menopause and the number of women entering menopause, quantifying alternative medication use and investigating its effect on HRQOL and HSU are essential. This study examines the: 1) effect of menopause on HRQOL; 2) use of alternative therapy for menopause and its effects on HRQOL; and 3) impact of menopause on HSU. To accomplish these goals, this study employs a novel, computerized data collection system. [unreadable] [unreadable] This research will develop a context for future studies, including randomized trials of the impact of non-traditional treatments on HRQOL and HSU. It will facilitate the candidate's transition to an independent health services researcher examining the impact of biologic and sociologic factors on HRQOL and HSU. [unreadable] [unreadable]